摘要： 迷走神经刺激术作为一种成熟的神经调控技术，自获批用于药物难治性癫痫的辅助治疗以来，其适应证范围不断拓展，截至2025年已批准用于药物难治性癫痫、难治性抑郁症、肥胖和脑卒中后上肢运动功能障碍，此外，在心血管疾病、炎症性疾病等领域亦展现出治疗潜力。本文综述植入式迷走神经刺激术的临床应用现状，重点梳理其在药物难治性癫痫、抑郁症、肥胖等核心适应证中的疗效证据，探究其作用机制，并展望未来适应证拓展方向及面临挑战，以为优化临床治疗策略及推动该领域研究进展提供理论依据与临床参考。

关键词: 迷走神经刺激术, 耐药性癫痫, 抑郁症, 肥胖症, 卒中, 运动障碍, 上肢, 心力衰竭, 炎症, 综述

Abstract: Vagus nerve stimulation (VNS) as an established neuromodulation technique, has seen a continuous expansion in its range of approved indications since its initial approval for the adjunctive treatment of drug-resistant epilepsy. As of 2025, the Food and Drug Administration (FDA) has approved VNS for drug-resistant epilepsy, treatment-resistant depression, obesity, and post- stroke upper limb motor rehabilitation. Furthermore, it has demonstrated therapeutic potential in areas such as cardiovascular diseases and inflammatory disorders. This narrative review examines the current clinical applications of implantable VNS, with a focus on evaluating the evidence for its efficacy in core indications including drug- resistant epilepsy, depression, and obesity. It also explores the underlying mechanisms of action and discusses future directions for the expansion of indications as well as the associated challenges. The aim is to provide a theoretical foundation and clinical reference for optimizing treatment strategies and advancing research in this field.

Key words: Vagus nerve stimulation, Drug resistant epilepsy, Depressive disorder, Obesity, Stroke, Motor disorders, Upper extremity, Heart failure, Inflammation, Review

中图分类号: 

• R741

• R651